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Jacobus, Evelyn
Jow,i v ueenJ ur J rINE VIEW CEMCTERY and CREMATORIUM QUAKER ROAD, QUEENSOURY, NEW YORK 12801 (518) 798 4 72G (518) 793-9777 Funeral Dirictor/9Ll (,9A/D_4•-8 ��T [Lime LJ1S J / k/-�C�,��/1� 1 �7 C4,9 Case No. # YoZ. )ale of Cremation 3-/ f-902 'ime Cremation Started 6 , 5j /9,44 , 'ime Cremation Completed` ii9 r9/M ype of Container -"�(el:2�/J )7D /5 // /'75-k" ©f 7-6/e- ,z)/5 d /y ^rrti�r.k s 1b?r i 3!1/CW,/P ON ,/c ,'�,3 4',' i 11 11 — %037-f/A1 ,, _�l �l . fir:i 7 "I'm / I I II g;3 ,g,,vl At Q Boat Uo &JN